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Journal Feed Weekly Wrap-Up

We always work hard, but we may not have time to read through a bunch of journals. It’s time to learn smarter.
Originally published at JournalFeed, a site that provides daily or weekly literature updates.
Follow Dr. Clay Smith at @spoonfedEM, and sign up for email updates here.

#1: What’s the Best Migraine Cocktail?

Spoon Feed —
There was no clear choice for single-agent pain control, but chlorpromazine IV/IM was among the most effective for pain relief at two hours, and IV/IM ketorolac was among the worst.

Source
Effectiveness and Safety of Pharmacologic Therapies for Migraine in the Emergency Department: A Systematic Review and Bayesian Network Meta-analysis. Ann Emerg Med. 2025 Apr;85(4):313-329. doi: 10.1016/j.annemergmed.2024.11.004. Epub 2024 Dec 14. PMID: 39674934

#2: Does 24 to 48-Hour Holter Monitor Help in Syncope?

Spoon Feed —
Short-term ambulatory cardiac monitoring has diagnostic usefulness, although limited, in patients discharged from the emergency department.

Sources
Diagnostic yield of 24 to 48-hour ambulatory cardiac monitoring in discharged emergency department patients. Am J Emerg Med. 2025 Apr 7;93:170-175. doi: 10.1016/j.ajem.2025.04.012. Epub ahead of print. PMID: 40215590

#3: How Good Are Decision Rules for Pediatric Septic Joint?

Spoon Feed —
In children with non-traumatic limp, existing clinical decision rules for septic arthritis performed poorly, with reduced range of motion emerging as the strongest individual predictor – despite being excluded from current tools.

Source
Test characteristics of clinical findings and clinical decision rules for the diagnosis of septic arthritis in children with an acute limp presenting to the emergency department: a prospective observational study. Emerg Med J. 2025 Apr 8:emermed-2024-214607. doi: 10.1136/emermed-2024-214607. Epub ahead of print. PMID: 40199562

#4: Should We Use Oxygen During Pediatric Sedation?

Spoon Feed —
This RCT found fewer desaturation events with supplemental oxygen via both low- and high-flow nasal cannula during pediatric procedural sedation.

Source
Oxygen supplementation in pediatric sedation-prospective, multicenter, randomized controlled trial. Anesthesiology. 2025 Apr 11. doi: 10.1097/ALN.0000000000005500. Epub ahead of print. PMID: 40215365

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